Immunologic Pattern of Hepatitis B Infection among Exposed and Non-Exposed Babies in A PMTCT Program in Low Resource Setting: Does Every Exposed Newborn Require 200IU of Hepatitis B Immunoglobulin?
- *Corresponding Author:
- Onakewhor JUE
Department of Obstetrics and Gynecology
University of Benin Teaching Hospital, Benin City
Nigeria and Institute of Human Virology
University of Maryland School of Medicine
Baltimore, Maryland, United States of America
E-mail: [email protected]
Received date: July 30, 2013; Accepted date: September 18, 2013; Published date: September 22, 2013
Citation: Onakewhor JUE, Charurat M, Matthew O, Osagie E, Asemota MO, et al. (2013) Immunologic Pattern of Hepatitis B Infection among Exposed and Non-Exposed Babies in A PMTCT Program in Low Resource Setting: Does Every Exposed Newborn Require 200IU of Hepatitis B Immunoglobulin? J Vaccines Vaccin 4:207. doi: 10.4172/2157-7560.1000207
Copyright: © 2013 Onakewhor JUE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Hepatitis B (HBV) is a vaccine-preventable infection. Vaccination programs instituted for virtual elimination of vertical and horizontal transmission are rarely evaluated. The prohibitive cost of HBV immunoprophylaxis (HBIG) engenders restrictive access in low-resource settings. Objective: Comparison of the immunologic pattern of HBV seromarkers and mother-to-child transmission (MTCT) rates among exposed and non-exposed babies who received either standard 200 iu or 100 iu HBIG in resource low settings. Method: This prospective pilot observational study involved a cohort of HBV-infected pregnant women and exposed babies and HBV-uninfected women-baby pairs as control at the Department of Obstetrics and Gynecology, UBTH, Nigeria. HBV seromarkers were detected using rapid, direct, third generation immunochromatographic test for qualitative monoclonal and polyclonal anti-HBsAg antibodies. Reactive samples were reanalyzed using LumiQuick HBV-5 panel test for visual detection of HBs-antigen, anti-HBs-antibodies, HBe-antigen, anti-HBe antibodies, anti- HBc(IgG/IgM) antibodies. Reactive samples were confirmed with ELISA. Exposed babies were “self-selected” into receiving either 200 IU or 100 IU HBIG within 12 hours of birth plus 3-dose course of HBV vaccine. Outcome measures were incidence of MTCT of HBV, pattern of immunologic response for HBV seromarkers and proportion of vaccine non-responders. Results and conclusion: The MTCT rate was 0.0% for all groups with no homogenous pattern of maternal to fetal transfer of HBV seromarkers. The overall rate of non-response to vaccination was high (8.0%) with exposed infants being poorer responders (17.1%) to vaccination p<0.01. We advocate introduction of HBIG as integral part of care into the NPI program and multicenter studies to evaluate our findings before policy change.